THE DULUTH CLINIC, LTD (NPI# 1285664995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285664995 |
| Entity Type | Organization |
| Organization Name | THE DULUTH CLINIC, LTD |
| Other Organization Name | SUPERIOR CLINIC |
| Practice Address |
3500 Tower Ave Superior WI 54880-5335 |
| Practice Telephone | 7153955454 |
| Mailing Telephone | 7153955454 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2016-01-18 |
| Authorized Official Name | TERRY JACOBSON (COO) |
| Authorized Official Telephone | 7158177014 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S DULUTH CLINIC HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1285664995 | 05 |
| Other Name | Type Code |
|---|---|
| Superior Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467750364 | The Duluth Clinic, Ltd | Pharmacy | 802 11th St Ste C, Two Harbors, MN 55616-1413 | 2011-03-02 |
| 1881633238 | The Duluth Clinic, Ltd | Clinic/Center | N10504 Grandview Ln, Ironwood, MI 49938-9621 | 2006-06-04 |
| 1356389316 | The Duluth Clinic, Ltd | Clinic/Center | 400 Nw 1st Street, Chisholm, MN 55719-1706 | 2006-06-03 |
| 1780621508 | The Duluth Clinic, Ltd | Clinic/Center | 730 E 34th St, Hibbing, MN 55746-5109 | 2006-06-01 |
| 1982641791 | The Duluth Clinic, Ltd | Clinic/Center | 405 W 3rd Ave N, Box 392, Aurora, MN 55705-1247 | 2006-06-01 |
| 1235176058 | The Duluth Clinic, Ltd | Clinic/Center | 4855 W Arrowhead Rd, Hermantown, MN 55811-3936 | 2006-06-01 |
| 1538506894 | The Duluth Clinic, Ltd | Clinic/Center | 901 9th St N, Virginia, MN 55792-2325 | 2013-05-28 |
| 1003114539 | The Duluth Clinic, Ltd | Pharmacy | 1502 London Rd, Suite 101, Duluth, MN 55812-1788 | 2011-03-08 |
| 1437457330 | The Duluth Clinic, Ltd | Pharmacy | 99 Edison Blvd, Suite L, Silver Bay, MN 55614-1211 | 2011-03-02 |
| 1902103831 | The Duluth Clinic, Ltd | Clinic/Center | 211 S Boundary Ave, Proctor, MN 55810-2306 | 2011-02-11 |
| Street Address |
3500 TOWER AVE |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801872080 | Vicki Brady | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-5335 | 2005-12-19 |
| 1659911014 | Mary K Robinson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2020-01-13 |
| 1265093413 | Paige Lois Slemmons | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2019-06-27 |
| 1164994513 | Elaina A Fischer | Nurse Practitioner | 3500 Tower Ave, Superior, WI 54880-4491 | 2018-12-26 |
| 1992229579 | Renee Christine Karth-pearson | Social Worker | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-07-26 |
| 1821518267 | Ryan Morgan | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-27 |
| 1639699200 | Nicholas C. Ellefson | Family Medicine | 3500 Tower Ave, Superior, WI 54880-4491 | 2017-06-23 |
| 1760837819 | Eric James Estes | Physical Therapist | 3500 Tower Ave, Superior, WI 54880-4491 | 2016-04-26 |
| 1710352018 | Christina Drexler | Occupational Therapist | 3500 Tower Ave, Superior, WI 54880-5395 | 2015-12-11 |
| 1063881399 | The Duluth Clinic, Ltd. | Pharmacy | 3500 Tower Ave, Suite C, Superior, WI 54880-4685 | 2015-09-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861695868 | Michael A Spector | Anesthesiology | 346 Onyx Way, Superior, CO 80027-4651 | 2007-06-07 |
| 1801866207 | Dana J Smith | Anesthesiology | 300 Center Dr, Ste G #111, Superior, CO 80027-8633 | 2006-01-26 |
| 1770639452 | Lief Sorensen | Anesthesiology | 80 Health Park Dr, Suite 50, Superior, CO 80027-9584 | 2007-01-26 |
| 1982767414 | John William Gildersleeve | Anesthesiology | 3500 Tower Ave, Superior, WI 54880-5335 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619431756 | Vision Anesthesia, Sc | Anesthesiology | 10200 W Innovation Dr Ste 700, Milwaukee, WI 53226-4827 | 2019-01-23 |
| 1699294520 | Anthony R Mars | Anesthesiology | 303 Mallard Way, Marinette, WI 54143-3370 | 2017-09-12 |
| 1861912107 | Somnos, Sc | Anesthesiology | 3305 N Ballard Rd Ste A, Appleton, WI 54911-9001 | 2017-06-27 |
| 1154850972 | Polykarpos Anesthesia LLC | Anesthesiology | 8400 Lakeview Pkwy Ste 800, Pleasant Prairie, WI 53158-5819 | 2017-06-06 |
| 1962866038 | Julie Frances Harvey | Anesthesiology | 9156 W Michigan St, Milwaukee, WI 53226-4574 | 2016-04-05 |
| 1962898742 | Brian Barreda | Anesthesiology | 5755 Monticello Way, Fitchburg, WI 53719-1603 | 2015-04-08 |
| 1962807982 | Robert Sanders | Anesthesiology | 1002 Willow Ln, Madison, WI 53705-1137 | 2014-11-03 |
| 1649606898 | Alan Herbert Goldberg | Anesthesiology | 1800 N Prospect Ave, Apt. 11c, Milwaukee, WI 53202-3070 | 2013-09-19 |
| 1235471699 | John Joseph Vondrell | Anesthesiology | 2025 Burnwood Ct, Brookfield, WI 53045-4814 | 2013-03-25 |
| 1497008205 | Boyi Gao | Anesthesiology | 6401 Offshore Dr, Madison, WI 53705-4387 | 2012-10-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.